Community health improvement processes that yield community health assessments (CHAs) and community health improvement plans (CHIPs) provide data and a process to determine key community priorities and take action and are ideally collaborative endeavors. Nationally, increased focus on CHAs and CHIPs highlights the role that Academic Health Departments or other local health department (LHD)-academic linkages can play in completing CHAs and CHIPs. Drawn from the experiences of 5 LHD-academic partnerships that participated in a national demonstration and a detailed account of the experience of one, this article presents how such linkages can support CHA and CHIP work, ways to anticipate and overcome challenges, and the tangible benefits that may be realized for both the LHD and the academic partner. Community health improvement processes are ripe opportunities for LHD-academic linkages and can be fruitful and mutually beneficial partnerships to be used in completing CHAs and CHIPs to measurably improve the public's health.

Context: The Foundational Public Health Services (FPHS) include a core set of activities that every health department should be able to provide in order to ensure that each resident has access to foundational services that protect and preserve health. Estimates of the public health workforce necessary to provide the FPHS are needed. Objective: This study assessed the potential use of an FPHS calculator to assess health department workforce needs. Design and Setting: Qualitative interviews were conducted via Zoom in December 2020-January 2021. Participants: Seventeen state and local public health leaders. Main Outcome Measures: Qualitative insights into the potential use of an FPHS calculator. Results: Almost all participants expressed that a reliable estimate would help them justify requests for new staff and that a calculator based on the FPHS would help organizations to critically assess whether they are meeting the needs of their communities and the core expectations of public health. Although participants expected that a tool to calculate full-time equivalent needs by the FPHS would be helpful, some participants expressed concerns in regard to using the tool, given ongoing workforce issues such as recruitment challenges, hiring freezes, and funding restrictions. An anticipated positive consequence of using this tool was that it may lead to cross-training the workforce and result in more diverse expertise and skills among existing workers. The other unintended consequences were that an FPHS calculator would require a substantial amount of time assessing the current FPHS efforts of existing staff and the results of the FPHS gap estimate could become the bar rather than the minimum needed. Conclusions: The current public and political focus on public health infrastructure as a result of the COVID-19 pandemic has created a window of opportunity to create change. An FPHS-based staffing tool may help transform public health and initiate a new era.

The research goal was to describe local health department community health improvement plans and hospital implementation strategies, assessing the extent to which they address the social determinants of health. In 2014, we used a grounded theory approach to conceptualize the extent of social determinant efforts in a purposive sample of improvement plans and implementation strategies (N = 12) taken from the community health assessment database pilot project (N = 502). We developed the Community Health Improvement Matrix (CHIM), categorizing public health activities according to target and prevention levels. In 2016, we surveyed NACCHO's Performance Improvement Workgroup (N = 9) using CHIM categories. In 2017, we tested the interrater reliability of the CHIM through an analysis of stories in 30 states (N = 101). We shared the CHIM in conferences, trainings, and focused conversations. The CHIM provides a framework for local public health partners to work together to address social determinants.